during an annual physical by the occupational rn working in a corporate clinic a male employee tells the rn that his high stress job is causing troubl
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HESI RN

Quizlet HESI Mental Health

1. During an annual physical at the corporate clinic, a male employee expresses to the RN that his high-stress job is causing trouble in his personal life. He mentions getting so angry while driving to and from work that he has considered 'getting even' with other drivers. How should the RN respond?

Correct answer: B

Rationale: The correct response for the RN is to advise the employee not to act impulsively when feeling angry. This approach helps the individual learn to manage anger in a constructive manner, reducing the likelihood of potential conflicts. Choice A is incorrect because although acknowledging that anger can escalate into confrontations is valid, it does not provide immediate guidance on managing the anger. Choice C focuses on the dangers of expressing anger to strangers but does not address the core issue of managing anger. Choice D simply acknowledges the employee's feelings without providing guidance on how to address the situation effectively.

2. Which client statement suggests to the nurse that the client is using the defense mechanism of projection to deal with anxiety related to admission to a psychiatric unit?

Correct answer: B

Rationale: The correct answer is B because the client is projecting their aggressive impulses onto an inanimate object, the wall, instead of accepting their own feelings. This statement reflects the defense mechanism of projection. Choice A is not projection; it is an explanation of why the client is there. Choice C indicates acceptance of the facility and does not involve projection. Choice D is a denial statement rather than projection.

3. A male client with a long history of alcohol dependency arrives in the emergency department describing the feeling of bugs crawling on his body. His BP is 170/102, pulse rate is 110 bpm, and his blood alcohol level (BAL) is 0 mg/dl. Which medication should the nurse administer?

Correct answer: D

Rationale: In this scenario, the client is experiencing hallucinations and symptoms of alcohol withdrawal. Lorazepam (Ativan) is the appropriate choice as it helps manage withdrawal symptoms, including hallucinations and elevated blood pressure in alcohol-dependent clients. Haloperidol (Haldol) (Choice A) is an antipsychotic but is not the first-line treatment for alcohol withdrawal symptoms. Thiamine (Vitamin B1) (Choice B) is essential in alcohol withdrawal treatment for preventing Wernicke's encephalopathy, but in this case, addressing the acute withdrawal symptoms is the priority. Diphenhydramine (Benadryl) (Choice C) is an antihistamine that may help with itching or mild anxiety but is not the preferred choice for managing alcohol withdrawal symptoms like hallucinations and elevated blood pressure.

4. During the admission assessment, a female client requests that her husband be allowed to stay in the room. When the RN notes a discrepancy between the client’s verbal and nonverbal communication, what action should the RN take?

Correct answer: A

Rationale: During a client assessment, noting and documenting nonverbal messages is important as it captures the full context of the client’s communication. Nonverbal cues can often reveal underlying emotions or issues that may not be expressed verbally. Asking the client’s husband to interpret the discrepancy (Choice B) may not be appropriate as it could potentially breach the client's privacy and trust. Ignoring nonverbal behavior (Choice C) can result in missing important cues that could impact the care provided. Integrating verbal and nonverbal messages (Choice D) is beneficial, but the initial step should be to pay close attention and document the nonverbal messages to fully understand the client's communication.

5. The nurse is planning client teaching for a 35-year-old client with early alcoholic cirrhosis. Which self-care measure should the nurse emphasize for the client’s recovery?

Correct answer: D

Rationale: Alcohol abstinence is the most critical self-care measure for a client with early alcoholic cirrhosis. Continued alcohol consumption can lead to further liver damage and worsen the condition. Support group meetings may offer emotional support but do not address the root cause of the issue. While vitamin supplements and a nutritious diet are important for overall health, alcohol abstinence takes precedence in managing cirrhosis caused by alcohol consumption.

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